A few days ago I wrote this screed of disdain about David Brooks data-less, thoughtless complaint about the vapid sex lives of Kids These Days™.* I have more than once commented on the evil consequences of marrying sexual queasiness to bad science, social or otherwise — and it struck me that it is important to remember that Brooks’s queasiness about sex has a broader context and worse consequences.
The thought came to me as I was reading my pre-pub copy (what used to be called a galley) of Rebecca Skloot’s marvelous new book The Immortal Life of HEnrietta LAcks. Rebecca has written a work that is proximately the story of HeLa — the most ubiquitous (some would say ferocious) human cell line used in modern biology — and the woman from whom those cells were derived, without her knowledge or permission. It’s more than that, of course — an inquiry into race and its twisted history in America, family, medical practice and medical ethics, the autonomy — or lack therof — with which we all inhabit our own bodies, and much more besides. I’ll blog about it properly closer to pub date, but put this one on your list.
Within all that, the factoid that got me thinking was Rebecca’s discussion of the particular type of cancer that killed Henrietta Lacks so swiftly and cruelly: cervical cancer, the sequel to her multiple infections with HPV-18, one of the most malign of the 100+ strains of Human Papilloma Virus.
HPV infection was and is an epidemic. In 2008, the Centers for Disease Control reported that
HPV is the most common sexually transmitted infection in the U.S., with about 20 million people currently infected. Women have an 80 percent chance of getting HPV by the time they are 50. HPV is most common in young people who are in their late teens and early 20s.
That is: about 7 percent, give or take, of the American population — closer to ten percent of the adult population**–are infected with a virus whose consequences range from nothing to death in predictable proportions. The same CDC report tells us that each year 11,000 women are diagnosed with cervical cancer, and that 3,600 will die of it.
For those of you keeping score, the number of women who will die this year of the disease that killed Henrietta Lacks is about 80% of the total US military deaths in Iraq since 2003 — 4363, according to the latest AP count. It is greater than the number of combat deaths in that period: 3,476.
There is this difference of course: death is a necessary component of battle. War is the imposition of national will by violence, in one short hand definition, and within that context, people will die.
By contrast, no one — or rather, within a generation, very close to no one — need die of HPV infection. The HPV vaccine, approved by the FDA in 2006, protects against four of the strains of HPV, including those that cause genital warts and cancer. It is effective, according to the CDC, and safe:
As of June 30, 2008 VAERS has received a total of 9,749 reports of potential adverse events following HPV vaccination. Ninety-four percent (94%) of these reports were about non-serious adverse events.
Six percent (6%) of adverse events reported for the HPV vaccine were considered serious, which is about half of the average number of serious reports for other vaccines. In comparison, the overall average in VAERS for any serious adverse event following vaccination ranges from 10% to 15%; therefore, the percentage of serious reports for Gardasil® is less than the overall average for other vaccines.
The CDC goes on to caution that the number of adverse events actually caused by the virus vaccine is almost certainly lower than that number, due to the post hoc ergo propter hoc problem.
The virus vaccine is recommended for girls aged 11-12. Why? Because this is before the age of likely infection, given that HPV is a sexually transmitted pathogen.
We all know where this goes. The notion of protecting girls from a deadly disease transmitted in the context — oh get the fainting couch ready — of the sexual lives of their older selves is terrifying, at least to some.
So much so that those terrified of especially female sexual appetite and expression (see for an allegedly respectable example, Chunky Reese Averse Ross Douthat) would rather kill people than acquiesce in the possibility that human beings might on occasion make the beast with two backs.
Recall: Texas secessionist Governor Rick Perry wasn’t always 100% crazy. Back when the loon quotient was down to no more than 95% or so, he actually, in a moment of clarity in 2007, signed an order that all require all sixth grade girls in Texas to receive the HPV vaccine. The response? As you’d expect. Texas legislators “rushed to file bills that would override the governor’s order, which they said revokes parental rights and could encourage young girls to be promiscuous.”
To his credit Perry stood up for modern public health:
Providing the HPV vaccine doesn’t promote sexual promiscuity any more than the Hepatitis B vaccine promotes drug use,” Perry said Monday. “If the medical community developed a vaccine for lung cancer, would the same critics oppose it, claiming it would encourage smoking?”
Soon, though — damn soon — in fact, he lost. Though he complained — accurately, that the legislators who had voted in favor of the bill overturning his executive order would rather tell women that “We could have prevented this disease for your daughters and your granddaughters, but we just didn’t have the gumption to address all the misguided and misleading political rhetoric,” he lacked the votes to prevent his veto from being overturned, and allowed the bill, unsigned, to become law.
Perry, it should be noted, still defends this decision. I have no time for just about everything Perry stands for – but on this one, he has it right.
So let’s recap: we face a disease that kills more women in this country each year than have died in battle in the last six in our war in Iraq….
…that will be allowed to persist in the lives of our daughters because to some people it is more important to pretend that human beings don’t have sex with more than one person in their lives than it is to prevent wholly avoidable suffering.
So, finally, to return to why I find David Brooks’s maundering about the sex lives of New Yorkers so pernicious is not just because of the gaping crater of intellectual shoddiness at its heart: it that he offers a well-spoken version of the attitude that declares, whatever may actually happen in real human experience, women shouldn’t have the temerity to uncross their legs. Remember the corollary of that belief as well: if they do, then, by gum, disease, distress and death are merely the appropriate consequences for such sin.
Last note: when ever I hear the term “value voters” I throw up in my mouth. The single central value of just about any ethical system, including those advanced by the sages of traditional religion, is that it is wrong to use other people as objects, rather than subjects, individuals of intrinsic value. Requiring others to die to avoid unpleasant contradiction with one’s own value system is not a virtue. It is, in the only true sense of the word, the very definition of a sin.
A pox upon them.
I mean that literally.
Oh — and one more thing. If anyone wants to draw the obvious connection to the current health care debates (Joe Stupak, are you listening? Senators?) then I think that is an entirely appropriate link. The entire anti-health care movement is in the end a decision to allow innocents to die in large numbers in order to achieve other ends; it sacrifices individuals in the service of either or both abstract “values” and the financial interests of various elites. Mere sin hardly covers the case; evil is more like it.
*I later found out that Brooks’ silliness was deeper than I thought, for I chanced across the original article in New York magazine in which the editors described the process by which they accumulated the sex diaries that so confounded the gentle Mr. Brooks. These were, which I’m sure will surprise no one, wholly selected for maximum effect. Producing social commentary on the basis of sought-and-found soft porn purveyed to prop up an at-risk publishing model is something only the credulous or the contemptuous-of-their-readers would attempt. Consider this an exercise for the readers to decide which it might be.
**and yes, I know that plenty of under-18s will have HPV infections. This is numerical shorthand here — an attempt to express scale. It is not, as I hope the language makes obvious, a precise claim.
Update: minor but crucial edits above (for “virus” read “vaccine” twice) thanks to the eagle eye of Lovable Liberal.
Images: Albrecht Dürer, “The Revelation of St John: 4. The Four Riders of the Apocalypse” 1497-1498
Berthe Morisot, “The Balcony” 1872